Rmd Details

Form DS 621, also known as the "Statement of Financial Interests," is a form that all federal employees and officers must complete on an annual basis. The form requires individuals to disclose any financial interests they have that could potentially conflict with their government duties. Completing Form DS 621 is important for ensuring transparency and preventing conflicts of interest.

This quick guide can help you determine how long it'll require you to fill out form ds 621, how many pages it has, and a few other unique details about the file.

QuestionAnswer
Form NameForm Ds 621
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesDeferred, apple bank online distribution form, affirm, RMDs

Form Preview Example

IRA DISTRIBUTION FORM

Please complete all of the information requested below:

1. PLAN TYPE

TRADITIONAL

Apple Bank for Savings

BRANCH #/DEPARTMENT

PLAN #

ROTH

SEP

2. ACCOUNT OWNER INFORMATION

Name:

 

First

Middle

Last

Address:

 

 

 

 

 

 

 

 

 

 

Street

 

 

 

 

 

 

 

 

City

State

Zip Code

Date of Birth:

Social Security Number:

 

 

 

 

 

 

 

Home Phone:

Business Phone:

 

 

 

 

 

 

 

 

 

 

 

 

3.REASON FOR DISTRIBUTION

Regular Distribution (after age 59-1/2) Mandatory Distribution (After age 70-1/2)

Premature Distribution (before age 59-1/2; possible IRS penalty) Premature Distribution (before age 59-1/2; exempt from IRS penalty) Internal Transfer

Death (complete Section 5; additional documentation required) Disability (additional documentation required)

Remove an excess contribution made for the current year Remove an excess contribution made for the prior year Other _________________________________

(conversion to Roth, Revocation, Recharacterization, etc.)

4. DISTRIBUTION INSTRUCTIONS

Required Minimum Distribution (RMD)*

Close Account(s) Specified Amount(s)

Other _______________________________

Interest only – Installment Payments: Monthly Quarterly

Installment payment based on Uniform Lifetime Table

Installment payments based on Joint Life and Last Survivor Expectancy Table Installment payments based on the Single Life Expectancy Table

*RMD’s not required for Roth during participant’s lifetime

Frequency:

Immediately

At Maturity

Installments:

Monthly

Quarterly

Semi-Annually

Annually

Please indicate month in which distributions are to start

Deferred Distribution: If you reach age 70-1/2 this year, you may elect to defer this year’s distribution up to April 1st of the following tax year. You are allowed to defer this distribution only for the year that you reach age 70-1/2. If you defer your distribution until next year, two withdrawals will be made in the same year. Please indicate which month you would like your deferred distribution:

January

February

March

Federal Income Tax Withholding Election: You must select one, withholding options as noted below. If you do not we are required to automatically withhold from your taxable payments as required by Federal Law.

Do not withhold federal income tax from my payments

Withhold federal income tax from my payments (10% -normal)

I elect to have the amount of $ withheld from my distribution payment

Other percent

 

%

DS-621 (04/2006)

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Method of Payment

Check mailed to recipient’s address

Deposit to IRA owner’s Apple Bank Savings Account:

Checking, NOW, or Money Market Account #

Specify retirement account(s). List numbers below

 

#

 

$

#

 

$

#

 

$

Check mailed to recipient of funds in Section 5 Savings Account #

Special handling instructions

Specified Amount(s)

Please note that early withdrawals from time deposit accounts may result in interest penalties. See account disclosures.

5.DISTRIBUTION DUE TO DEATH

* The recipient’s signature must be guaranteed. Recipient of funds:

Designated IRA beneficiary

Legal representative of estate

Name:

 

First

Middle

Last

Address:

 

 

 

 

 

 

 

 

Street

 

 

 

 

 

 

City

State

Zip Code

Date of Birth:

Social Security Number:

 

 

 

 

 

Home Phone:

Business Phone:

 

 

 

 

 

6.AUTHORIZATION By signing this request:

You authorize us to make a withdrawal from the above Apple Bank IRA in the manner and for the reason indicated. You affirm that the withdrawal is permitted under the Apple Bank IRA and meets all legal requirements of the Internal Revenue Code. You acknowledge that Apple Bank may rely on your affirmation and is not liable for any tax or other consequences, nor for any penalties, however incurred in connection with this withdrawal.

Name of individual receiving funds (please print)

Signature

Date

 

 

 

7.Approved by APPLE BANK FOR SAVINGS

Authorized Signature

Date

DS-621 (04/2006)

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